“…On one hand, this condition is difficult to diagnose with routine urologic investigations and on the other hand, antenatal detection of ureteric valves by ultrasound has been reported [3].…”
“…On one hand, this condition is difficult to diagnose with routine urologic investigations and on the other hand, antenatal detection of ureteric valves by ultrasound has been reported [3].…”
“…Valves in the upper ureter present as obstruction at ureteropelvic junction and can be accurately diagnosed with retrograde pyelography. On one hand, this condition is difficult to diagnose with routine urologic investigations and on the other hand, antenatal detection of ureteric valves by ultrasound has been reported [4]. Management of children with ureteric valves largely involves surgical intervention wherein the segment of ureter with the valve is excised and ureteroureteric (for mid and lower ureter) and pyeloureteral (for upper ureter) anastomoses are performed [5].…”
A B S T R A C TPrimary obstructed megaureter is a common urological condition in the pediatric age group. It is one of the differentials for congenital anomalies of the kidney and urinary tract that include a myriad of structural anomalies of the urinary tract. The obstructive conditions are usually managed conservatively unless there is deterioration in renal function, repeated urinary tract infection, or any other symptom such as abdominal pain on ipsilateral side and hypertension. Presented here is a case of left lower ureteral valve that was diagnosed as primary obstructed megaureter with pain in abdomen and reduced ipsilateral renal function wherein ureteral valve was detected incidentally intraoperatively. Excision of the valve with end to end uretero-ureteral anastomoses over a D-J stent, without resorting to ureteric reimplantation was successful in relieving the obstruction and hydronephrosis.
“…In the same paper, the authors found that these strictures are commonly associated with additional renal anomalies which can be diagnosed and characterized with MRU including contralateral mid-ureteral stricture, MCDK, collecting system duplication, paraureteral diverticulum, and ectopic ureterocele [ 20 , 23 ]. In addition to strictures, additional rare causes for hydroureteronephrosis include congenital ureteral valves [ 24 , 25 ] and ureteral fibroepithelial polyps [ 26 ], both of which can occur at various levels of the ureter and can be diagnosed with MRU, enhancing the surgical plan with this knowledge. Fig.…”
Purpose of ReviewIn this article, we describe the basics of how magnetic resonance urography (MRU) is performed in the pediatric population as well as the common indications and relative performance compared to standard imaging modalities.Recent FindingsAlthough MRU is still largely performed in major academic or specialty imaging centers, more and more applications in the pediatric setting have been described in the literature.SummaryMRU is a comprehensive imaging modality for evaluating multiple pediatric urologic conditions combining excellent anatomic detail with functional information previously only available via renal scintigraphy. While generally still reserved for problem solving, MRU should be considered for some conditions as an early imaging technique.
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